Abstract
Chemotherapy‐induced peripheral neuropathy (CIPN) frequently occurs in cancer patients. This side effect lowers the quality of life of patients and may cause the patients to abandon chemotherapy. Several medications (e.g., duloxetine and gabapentin) are recommended as remedies to treat CIPN; however, usage of these drugs is limited because of low efficacy or side effects such as dizziness, nausea, somnolence, and vomiting. From ancient East Asia, the decoction of medicinal herbal formulas or single herbs have been used to treat pain and could serve as alternative therapeutic option. Recently, the analgesic potency of medicinal plants and their phytochemicals on CIPN has been reported, and a majority of their effects have been shown to be mediated by glial modulation. In this review, we summarize the analgesic efficacy of medicinal plants and their phytochemicals, and discuss their possible mechanisms focusing on glial modulation in animal studies.
Highlights
In the past few years, our group has elucidated the potency of medicinal herbs and their phytochemicals on chemotherapy-induced peripheral neuropathy (CIPN) using animal models.36–39 We have shown the hypertrophy of glial cells in Chemotherapy-induced peripheral neuropathy (CIPN) models and the analgesic effect of medicinal herbs and their phytochemicals through inhibition of glial activation.36–38 According to the data reported by us and others, medicinal herbs and their phytochemicals are applicable to suppress CIPN, and these studies suggest that glia could be an efficient therapeutic target
In this review, we summarize and discuss the recent findings regarding the analgesic effects of medicinal herbs and phytochemicals and their glial modulation in CIPN animals (Table 1)
Analgesic effects on CIPN were observed after treatment with six medicinal herb formulas, 21 single medicinal herbs, and 21 phytochemicals
Summary
Chemotherapy is a standard first-line therapy for various types of cancer.1–3 chemotherapeutic agents, such as oxaliplatin, paclitaxel and vincristine, are neurotoxic.4–6 Due to this, more than 60% of chemotherapy-treated patients suffer from peripheral sensory symptoms approximately 24–48 h after chemotherapy infusion.7,8 Abnormal sensory symptoms after chemotherapy manifest as cold and mechanical allodynia in a glove-and-stocking distribution.9 Such neuropathic pain that occurs after chemotherapy lowers the quality of life (QoL) of patients and is one of the primary reasons why patients abandon chemotherapy.10–13 To treat these side effects, antidepressant or anticonvulsant drugs, such as duloxetine or gabapentin, are referred for patients as a first-line treatment; these drugs have been reported to be accompanied by dizziness, nausea, somnolence and vomiting.14–17Plants have long been used not just as food, and as drugs, since ancient times (e.g., using the willow tree for pain killers). Oral administration of NYT (1 g/ kg, 7 times) suppressed oxaliplatin-induced cold allodynia (acetone test) and mechanical hyperalgesia (von Frey test) in mice.
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